Even the way in which the Washington study data was presented was biased against VBAC. The article stated that spontaneous VBAC labor increased the risk of rupture 3.3-fold compared with repeat cesarean, a statistic quoted in media articles. This sounds alarming, but the absolute difference was four women per thousand, a miniscule number when you consider that two-thirds of women experiencing uterine rupture will suffer nothing worse than the cesarean they would have had in any case had they not decided on a VBAC. The study purporting to show that VBAC resulted in more major maternal complications, it should be noted, was also published in the New England Journal, as have other equally prejudiced editorials. This leads one to suspect that the obstetricians involved in the editorial process are using the journal to promote their agenda under the guise of journalistic objectivity.
To be fair, not every obstetrician who won’t do VBACs is willfully engaging in deception. Some are unconsciously suiting the facts to their beliefs. Some have been convinced by those they take as authorities that repeat cesarean is best. Some are glad to have an excuse to not do what they never wanted to do in the first place. Some have reluctantly bowed to pressure from their malpractice insurance company, hospital policy or colleagues. The result for you, though, is the same: the experts you trust to advise you on what is safest for you and your baby have abandoned that responsibility. With few exceptions, when obstetricians tell you planned repeat cesarean is the better option, they aren’t talking about your or your baby’s wellbeing; they are talking about their own.